Therapeutische Umschau. Revue thérapeutique
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Ankle sprains, burns, cuts and lacerated wounds, ingrowing toenail - topics, that are common in the general practitioner's office. Just peanuts? If they are correctly treated, yes, maybe. But if poorly diagnosed and badly treated they turn out to be troublesome for the patient and the doctor - a real "pain in the neck". Therefore competent treatment is mandatory, also for these "peanuts"!
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In over 95 % of shoulder dislocations, the humerus is displaced anteriorly, a trauma regularly seen in skiing- and mountainresorts. All physicians should be trained to diagnose and relocate a dislocated shoulder. A variety of techniques exist, but some are preferred due to fewer complications or easier execution. In the Bernese Alps, the self-relocation technique "Davos" (Boss-Holzach-Matter) and the "Baumann" technique are well established and well approved over the years - in the outdoors as well as in the surgeries.
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Acute urinary retention is a common emergency condition in elderly men. Transurethral and suprapubic catheterization are easy and safe procedures provided that a few simple rules are followed. Primarily, a transurethral catheter is placed if there is no urethral injury or stricture. ⋯ Alternatively, a suprapubic catheterization can be performed provided that no contraindication such as history or suspicion of transitional cell carcinoma is present. Optimal interventional conditions using ultrasound-guidance are mandatory in patients after abdominal surgery and with hemorrhagic diathesis in view of a safe and straight-forward placement of the suprapubic catheterization. In case of persistent bleeding after insertion of a suprapubic catheter, the suprapubic catheter should be replaced by one with a balloon blocked and kept under tension for several minutes.
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Our hospitals are suffering from an increasing run of "minor emergency cases". Those are simple medical or surgical ailments that could be taken care of by a general practitioner's office in a competent and cost efficient way. ⋯ It was shown that emergency room crowding has a negative impact on the quality of patient care. The establishment of an office run by a general practitioner within the hospital emergency room may result in a certain relief of the situation.